Cost-effectiveness and quality-of-life analysis of physician-staffed helicopter emergency medical services


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The long-term health outcomes and costs of helicopter emergency medical services (HEMS) assistance remain uncertain. The aim of this study was to investigate the cost-effectiveness of HEMS assistance compared with emergency medical services (EMS).


A prospective cohort study was performed at a level I trauma centre. Quality-of-life measurements were obtained at 2 years after trauma, using the EuroQol—Five Dimensions (EQ-5D) as generic measure to determine health status. Health outcomes and costs were combined into costs per quality-adjusted life year (QALY).


The study population receiving HEMS assistance was more severely injured than that receiving EMS assistance only. Over the 4-year study interval, HEMS assistance saved a total of 29 additional lives. No statistically significant differences in quality of life were found between assistance with HEMS or with EMS. Two years after trauma the mean EQ-5D utility score was 0·70 versus 0·71 respectively. The incremental cost–effectiveness ratio for HEMS versus EMS was €28 327 per QALY. The sensitivity analysis showed a cost-effectiveness ratio between €16 000 and €62 000.


In the Netherlands, the costs of HEMS assistance per QALY remain below the acceptance threshold. HEMS should therefore be considered as cost effective. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.